Endovascular therapy for severely calcified plaque at the superficial femoral artery using myocardial biopsy forceps

Shojiro Hirano; Atsushi Funatsu; Shigeru Nakamura; Takanori Ikeda

doi:10.1186/s42155-021-00257-z

Endovascular therapy for severely calcified plaque at the superficial femoral artery using myocardial biopsy forceps

CVIR Endovasc. 2021 Sep 15;4(1):69. doi: 10.1186/s42155-021-00257-z.

Authors

Shojiro Hirano¹, Atsushi Funatsu², Shigeru Nakamura², Takanori Ikeda³

Affiliations

¹ Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University, 5-21-16 Omorinishi, Ota-ku, 143-8540, Tokyo, Japan. shojiro.hirano@med.toho-u.ac.jp.
² Cardiovascular Center, Kyoto Katsura Hospital, Kyoto, Japan.
³ Department of Cardiovascular Medicine, Toho University Faculty of Medicine Graduate School of Medicine, Tokyo, Ota-ku, Japan.

Abstract

Background: Currently, the success rate of EVT for treating CTO of the SFA is high; however, EVT is still found to be insufficient in treating CTOs with severely calcified lesions. Even if the guidewire crosses the lesion, the calcifications may still cause difficulties during stent expansion.

Main text: A 78-year-old male had been reported to have intermittent claudication with chronic total occlusion (CTO) of the right superficial femoral artery (SFA). Angiography revealed severely calcified plaque (Angiographic calcium score: Group4a [1]) at the ostium of the SFA. Stenting posed a risk of underexpansion, causing the plaque to shift to the deep femoral artery. we decided to remove the calcified plaque using biopsy forceps. After removing the extended calcified plaque, the guidewire could cross easily, and the self-expandable stent was well dilated without causing the plaque to shift to the DFA.

Conclusions: Biopsy forceps may be used in some endovascular cases to remove severely calcified lesions. To ensure the safety of the patient, the physician must be adept at performing this technique before attempting it.

Keywords: Chronic total occlusions; Endovascular therapy; Superficial femoral artery.